Provider Demographics
NPI:1073692034
Name:FAYE, LEONARD JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:JOHN
Last Name:FAYE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 NATIONAL BLVD
Mailing Address - Street 2:STE# 340
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-4139
Mailing Address - Country:US
Mailing Address - Phone:310-470-1225
Mailing Address - Fax:310-475-8204
Practice Address - Street 1:10801 NATIONAL BLVD
Practice Address - Street 2:STE# 340
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-4139
Practice Address - Country:US
Practice Address - Phone:310-470-1225
Practice Address - Fax:310-475-8204
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC17395111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATAX ID 954769788OtherFAYE & FAYE CHIROPRACTIC,
CADC17395Medicare PIN
CATAX ID 954769788OtherFAYE & FAYE CHIROPRACTIC,